Last July, as he signed a Texas bill that prohibited abortion after 20 weeks and set new rules for physicians and clinics, Governor Rick Perry said “I am pro-life!” That claim is broad enough to be made by a champion of capital punishment: since 2001 he has overseen 261 executions in Texas. According to The Innocence Project, seven Texas men convicted of murder were exonerated in that period. As a physician who opposes capital punishment and is pro-choice regarding contraception and abortion, I did some terminological research.

The theological phrase “innocent life” has nothing to do with judicial law. It does not even refer to a newborn baby. The term comes from St. Augustine of Hippo (354-430), based on the story of Adam and Eve, who were innocent until they willfully sinned by eating the forbidden fruit. God expelled them from Eden and punished them and all their descendants with inevitable death. For Augustine, who had struggled with issues of sex and will, original sin came from–and thereby contaminated–human will.

Historian Elaine Pagels wrote, “Where earlier generations of Jews and Christians had once found in Genesis 1-3 the affirmation of human freedom to choose good or evil, Augustine… found in the same text a story of human bondage….as Augustine grew older he argued that…all humankind was fallen; and that the human will was incorrigibly corrupt.” Despite arguments against him from Pelagius and Julian, “Augustine’s argument has persuaded the majority of western Catholic and Protestant theologians to agree with him; and many western Christians have taken his interpretation of [Romans 7:15-18] for granted” (Adam, Eve and the Serpent, 97, 143).

Baptism, prayer, confession and the possibility of afterlife are some religious responses to this human dilemma. But “innocent life” specifically applies to the human being without will, the fetus, or unborn child. This explains why many believers are much more concerned with abortion than with infant mortality: the unborn is innocent, the newborn bears guilt for its nascent will, emblem of sin.

It occurred to me that, thanks to modern medical technology, we have a new form of innocent life: permanent vegetative state (PVS). The PVS patient, having lost consciousness and will, regains the innocence of the fetus. In Augustine’s time such patients died quickly, but now, with intubation and ventilator, they exist–free of will, though anything but free. The tragic case of Terry Schiavo (1963-2005; PVS from 1990), raised the issue to a furor. While there are hopes and arguments that such patients may get better, “better”–to Augustine–already describes the soul without will. For him and his followers the important life is hereafter and eternal; the fetus and the PVS patient are as innocent as human life on earth can be. The is the status hallowed by “pro-life” partisans.

Sperm and egg were only discovered in the 17th century with the invention of the microscope. Before that, “seed” described the invisible agents of human fertility. Although both fetus and newborn are helpless and wholly without responsibility, the baby is tainted with ancestral (original) sin, for which baptism is somewhat palliative. Legally and logically a fetus is not a person; vital statistics count the deaths of newborns but not fetal loss by miscarriage and abortion.

The U.S., despite its wealth and advanced health technology, has some 25,000 infant deaths before age one. Our infant mortality rating among countries of the world dropped from 12th in 1960 to 50th now. Despite this sorrow and waste, we hear much more about protecting “innocent life” against deliberate abortion than we do about helping women plan their pregnancies and helping newborns through better prenatal and postnatal care.

Sigmund Freud, the dominant psychological figure of the last century, was dismissive of conscious will–to him was lesser factor than biological impulse. Otto Rank, his follower and eventual critic, put human will on a higher plane: “one could fill volumes and libraries with the description of human acts of will and their beneficial and destructive effects… we seem to have a kind of universal guilt feeling as far as will is concerned…. the arch evil is the will, no matter whether one interprets it biologically like Freud as sex desire (libido), or like Adler sociologically as will to power, or pedagogically as obstinacy” (Will Therapy, 1936, 9-10).

In America today will is often admired, even glorified; in sports, business and politics, strong will carries the day. though it suffers from the glib assertion that you can be or achieve whatever you will. Acts of will coupled with technology unimaginable to Augustine have changed our lives and our vulnerable home, planet Earth. Human population growth threatens the planet. Most women everywhere prefer a two child family but too many lack the means–not the will–to achieve that goal. Population control is largely a matter of famine, disease and war. Effective birth control, a 20th century phenomenon, is still limited to a minority of women in the world. Augustinian theology makes contraception a sin for men and women, but men do not bear children and women cannot be priests. The health and well-being of families is compromised by the edicts of a sinner-turned-saint who lived 1,700 years ago.

Many Americans are ill-informed about sex and birth control, though our mass media thrive on sexual titillation and prime-time television brings up “erections lasting more than four hours.” Despite such endorsement of sexual activity, the media hardly acknowledge contraception. Many physicians are too busy or too shy to bring up the subject.

“Pro-life” activists restrict access to effective contraception, medical abortion and choices for the terminally ill. As a pro-choice physician I promote learning about contraception as basic sex education and defend access to safe medical abortion. That should not be a radical position in a nation that adopted religious freedom at birth.